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Introduction The strategies selected to provide health services to rural areas in lowincome countries are motivated in part by the following commonly held assumptions about existing health conditions and medical service demand patterns in such countries:(1) many Third World health problems are thought to be susceptible to elementary types of care and simple drugs that can be supplied by paraprofessionals;(2) conventional modern medical resources are thought to be located primarily in urban areas and therefore to be inaccessible to rural households; and (3) the economic aspects of the demand for medical care-income, time costs, and cash costs-are thought to be extremely important deterrents to using medical services. The idea that simple interventions, usually of a preventive type, will solve many rural health problems is probably incontrovertible. However, although the proper interventions can be dictated …